Abstract

Context Doctor competencies have become an increasing focus of medical education at all levels. However, confusion exists regarding what constitutes a competency versus a goal, objective or outcome.

Objectives This article attempts to identify the characteristics that define a competency and proposes criteria that can be applied to distinguish between competencies, goals, objectives and outcomes.

Methods We provide a brief overview of the history of competencies and compare competencies identified by international medical education organisations (CanMEDS 2005, Institute for International Medical Education, Dundee Outcome Model, Accreditation Council for Graduate Medical Education/American Board of Medical Specialties). Based upon this review and comparisons, as well as on definitions of competencies from the literature and theoretical and conceptual analyses of the underpinnings of competencies, the authors develop criteria that can serve to distinguish competencies from goals, objectives and outcomes.

Results We propose 5 criteria which can be used to define a competency: it focuses on the performance of the end-product or goal-state of instruction; it reflects expectations that are external to the immediate instructional programme; it is expressible in terms of measurable behaviour; it uses a standard for judging competence that is not dependent upon the performance of other learners, and it informs learners, as well as other stakeholders, about what is expected of them.

Conclusions Competency-based medical education is likely to be here for the foreseeable future. Whether or not these 5 criteria, or some variation of them, become the ultimate defining criteria for what constitutes a competency, they represent an essential step towards clearing the confusion that reigns.

Keywords

Publication History

Received 21 December 2006; editorial comments to authors 11 June 2007, 12 October 2007; accepted for publication 26 October 2007

Supporting Information

Appendix S1. American Board of Medical Specialties/Accreditation Council for Graduate Medical Education, CanMEDS 2005 and Institute for International Medical Education competencies aligned by common elements.

Appendix S2. American Board of Medical Specialties/Accreditation Council for Graduate Medical Education and Dundee Outcome Model competencies aligned by common elements.

Appendix S3. Analysis American Board of Medical Specialties/Accreditation Council for Graduate Medical Education competencies evaluated against the 5 criteria to show their viability.

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